Despite Reforms, State Auditor Finds Serious Burns and Head Contusions Undetected by Dept. Children and Families

BOSTON – An audit of the Massachusetts Department of Children and Families released today, December 7, by Massachusetts State Auditor Suzanne M. Bump found reforms to date have not enabled the agency to take a proactive approach to protecting the children in its care.

The audit found that Department of Children and Families:

Is not using all of the tools at its disposal to detect all serious bodily injury to children already in its custody,

Is not reporting all of these injuries to its oversight agency, the Office of the Child Advocate (OCA), and

Is not ensuring that all potentially criminal actions are referred to the District Attorney’s offices for investigation or prosecution.

In addition to these findings, Auditor Bump is also calling on Department of Children and Families to consider sexual abuse a critical incident, a designation which triggers immediate investigative action. “How can the agency not consider sexual abuse a serious injury to a child? It defies logic,” Bump said in a media statement.

Bump found that during the two year audit period, Department of Children and Families was unaware of 260 incidents of what appeared to be serious bodily injury to children in its care.

These incidents include: a 15-year-old with brain damage from a firearm injury, a 1-year-old with first- and second-degree burns on multiple body parts, and a 12-year-old with multiple head contusions that a physician determined were a result of an assault.

The audit notes that this deficiency was a result of Department of Children and Families relying on others to report occurrences of serious bodily injury to children rather than utilizing data sources that they have at their fingertips.

In order to establish a more proactive approach, Bump called on Department of Children and Families (DCF) to use MassHealth data to proactively identify incidents of serious bodily injury to children in its care. This data provides records of all medical treatments provided to an enrolled member that are billed to the program. Children in DCF care that have been removed from their home are enrolled in MassHealth, and DCF currently has access to claims data for these children but is not using it as a tool to identify serious medical incidents. In its response, DCF indicated it has not yet taken action to implement this recommendation because it did not believe this data was timely. Bump noted that despite DCF assertions, her office’s analysis shows that MassHealth claims data is timely and an effective tool to identify medical incidents involving children in DCF care.

“The children entrusted into DCF care are among the most vulnerable residents of the Commonwealth. This audit found that despite reforms, victimization of children in DCF’s care continues to occur unnoticed by the agency,” Bump said. “The work of DCF is incredibly difficult and extremely important. This is why it is so critical that the agency uses all of the tools at its disposal, such as MassHealth claims data, to identify and investigate physical harm to children in its care.”

Bump’s audit also noted that DCF does not consider sexual abuse a critical incident, and therefore does not report it to the Office of the Child Advocate (OCA), which is tasked with ensuring children involved in state care receive timely, safe, humane, and effective services. Defined by state law, critical incidents are those events that result in a fatality, near fatality, or serious bodily injury of a child. Bump’s office found 118 incidents of sexual abuse of a child in DCF care that were not reported to OCA. These incidents included two male employees at different DCF-contracted residential facilities who sexually abused three girls each; a 10-year-old who was raped by his father; a 4-year-old who was sexually abused by her mother; and a 17-year-old who was gang-raped by five assailants. In one case, a male who had sexually abused one child, abused the child’s sibling less than one year later. While officials indicated these incidents were investigated by DCF staff in collaboration with law enforcement, they told Bump’s staff that these occurrences did not meet the definition of a critical incident, and therefore were not reported to OCA. As a result of the audit, DCF indicated it is collaborating with OCA to address this issue.

“Clearly, we as a society must do more to confront and address sexual abuse. To say, as DCF has asserted, that sexual abuse should not be considered a critical incident, defies logic,” Bump said. “Again, by not reporting incidents of sexual abuse to the Office of the Child Advocate, the Department is hindering this important voice for children.”

Bump noted that Department of Children and Families is taking other steps in response to the audit to enhance its work, including:

Centralizing its reporting of critical incidents in which children in its care are involved;

Updating its procedures for referring incidents of abuse, neglect, and/or sexual abuse of children to district attorneys’ offices for investigation; and

DCF provides services to children 0 through 21 years of age who are at risk or have been victims of abuse or neglect, as well as their families. It provides services such as adoption/guardianship, foster care, housing stabilization, family support and stabilization, adolescent services, protective services, and other in-home supports to reduce risks to children. In Fiscal Year 2017, it served an average of 51,882 children each month and had an annual appropriation of $908 million.

The Office of the State Auditor conducts performance audits of state government’s programs, departments, agencies, authorities, contracts, and vendors. With its reports, the OSA issues recommendations to improve accountability, efficiency, and transparency. The OSA has identified approximately $1.3 billion in unallowable, questionable, or potentially fraudulent spending and saving opportunities for the Commonwealth since 2011. L